What are the possible mechanisms of inhibition of secretion of acid and pepsin have diabetics ?To a large extent these changes are associated with disorders of the structure of the gastric mucosa, with long-term development of diabetes, chronic gastritis with varying degrees of atrophy.Further, it is assumed importance in the genesis of gastric hyposecretion diabetic neuropathy.In diabetic patients with microangiopathy pathology small branching arterial bed may involve, firstly, vasa nervorum, thus becoming one of causes of neuropathy, and secondly, - disrupt blood flow in the gastric mucosa, which results can be a reduction insecretory activity of mucous membrane.In our clinic has been modified for studies in human blood flow in the gastric mucosa method clearance amidopirina shown the usefulness of this method to study the state of the gastric mucosa in various pathological conditions.Amidopirina clearance method has been used in patients with diabetes.It was found that if the rate of 12 health

y blood flow in the gastric mucosa averaged 47.1 + 3.2 ml / min, then 28 diabetic patients without microvascular this figure is 27.4 + 3.1 ml / min, and19 patients with retinopathy even lower, 15.9 + 1.8 ml / min.The reduction of blood supply to the gastric mucosa can be thus classified among the mechanisms of oppression and pepsinovydelitelnoy kislotoobrazovatelnoy functions of the stomach.Known role of endogenous histamine in the process of regulation of the activity of parietal cells of the gastric mucosa in physiological and pathological conditions.In the previous chapter we provide materials proving gistaminemii reduction in patients with diabetes.It is believed that this factor plays a role in the occurrence of gastric hyposecretion in diabetes.We have studied the degree of back diffusion of hydrogen ions through the stomach lining in some of the surveyed patients.

pepsin activity in gastric juice

group without microangiopathy with normoglycaemia and aglikozuriey characterized by increased secretion of hydrochloric acid in basal conditions and in response to chemical stimulation (the ninth group), but the difference with performance in healthy people is still essential.In diabetes with microangiopathy, in spite of the long-term compensation, oppression kislotoobrazovatelnoy function of the stomach was expressed significantly.Analysis of the results of the enhanced histamine test shows that the spare capacities of acid (the number of actively functioning parietal cells, documented that the sample) with long-term diabetes significantly reduced the differences with healthy people highly significant (P & lt; 0,001).Matching results were obtained by us gastrobiopsy criterion: the lowest levels of secretion of hydrochloric acid were observed in diabetic patients with morphologically confirmed atrophic gastritis.We compared the quantity of hydrochloric acid secretion after stimulation of histamine in a dose of 0.01 mg / kg and at a dose of 0.018 mg / kg to the morphological features of chronic gastritis with varying degrees of atrophy.The correlation coefficient was found to be 0.41 for the histamine dose of 0.01 mg / kg and 0.69 for a dose of histamine 0.018 mg / kg, ie. E. The relationship between the studied traits is natural, but it is moderate for a normal histamine test and high - for enhancedhistamine test.Here is an example.

pepsin activity in gastric juice in diabetic patients is reduced.The degree of inhibition of peptic activity in the longer duration of diabetes (when comparing the figures in the first and fifth groups of R & lt; 0,05).Establish a connection between the activity of pepsin and the severity of diabetes, the nature of the treatment and the presence or absence of microangiopathy failed.

When diabetes naturally increased secretion hexosamines and fucose.This is probably due (from the standpoint of the above sets out the concept of Spiro) increased formation of glycoproteins from glucose elevated glucose in absolute or relative insulin deficiency.The fact that the long-term normoglycemia hexosamines and fucose content in gastric juice in patients with diabetes becomes close to that of healthy people (ninth and tenth groups) confirms the validity of this assumption.

Tags: gistaminemiya, acid secretion, chronic gastritis